Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $101.60 / $106.21 / $423.00	Professional		$101.60	$106.21	$423.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $60.45 / $69.73 / $153.54	Professional	26	$60.45	$69.73	$153.54
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $31.87 / $36.67 / $84.04	Professional	TC	$31.87	$36.67	$84.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $75.47 / $122.93 / $163.47	Professional		$75.47	$122.93	$163.47
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.43 / $73.08 / $101.59	Professional	26	$50.43	$73.08	$101.59
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.14 / $50.60 / $62.01	Professional	TC	$21.14	$50.60	$62.01
HMSA Facility/Professional Professional Modifier Low / Median / High Price $52.65 / $66.00 / $150.43	Professional		$52.65	$66.00	$150.43
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $88.85 / $93.04 / $95.36	Professional	26	$88.85	$93.04	$95.36
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $57.39 / $57.39 / $57.39	Professional	TC	$57.39	$57.39	$57.39
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $111.16 / $130.78 / $152.57	Professional		$111.16	$130.78	$152.57
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $60.56 / $71.23 / $83.12	Professional	26	$60.56	$71.23	$83.12
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $50.60 / $59.53 / $69.45	Professional	TC	$50.60	$59.53	$69.45
United Facility/Professional Professional Modifier Low / Median / High Price $100.79 / $136.22 / $226.52	Professional		$100.79	$136.22	$226.52
United Facility/Professional Professional Modifier 26 Low / Median / High Price $60.56 / $74.20 / $176.96	Professional	26	$60.56	$74.20	$176.96
United Facility/Professional Professional Modifier TC Low / Median / High Price $36.40 / $59.73 / $62.28	Professional	TC	$36.40	$59.73	$62.28
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $84.29 / $122.80 / $227.40	Professional		$84.29	$122.80	$227.40
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $53.80 / $73.42 / $132.72	Professional	26	$53.80	$73.42	$132.72
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $36.09 / $53.58 / $76.98	Professional	TC	$36.09	$53.58	$76.98